Résumé
OBJECTIVE To observe the clinical efficacy and safety of albumin-bound paclitaxel combined with nedaplatin inductive chemotherapy followed by concurrent radiochemotherapy in the treatment of loco-regionally advanced nasopharyngeal carcinoma. METHODS The clinical data of 45 patients （observation group ） with loco-regionally advanced nasopharyngeal carcinoma（Ⅲ/Ⅳa stage ）who received albumin-bound paclitaxel combined with nedaplatin inductive chemotherapy in our hospital from August 2017 to July 2018 were retrospectively analyzed. Propensity score was used to match 45 patients（control group ）with loco-regionally advanced nasopharyngeal carcinoma who received docetaxel combined with cisplatin and fluorouracil inductive chemotherapy. After inductive chemotherapy ，both groups received intensity-modulated radiochemotherapy （IMRT）；observation group was additionally given concurrent nedaplatin chemotherapy ，and control groups was given concurrent cisplatin chemotherapy. Clinical efficacy and the incidence of ADR were compared between 2 groups. RESULTS All patients completed treatment and 3-year follow-up. After inductive chemotherapy and 1，3 months after concurrent radiochemotherapy ，there was no statistical significance in short-term response between 2 groups（P＞0.05）. There was no significantly difference in 3-years local control rate and 3-years free from distant metastasis between 2 groups（P＞0.05）. The incidences of leucopenia （grade 3 or above ）in the observation group were significantly lower than those in the control group ，and the incidence of peripheral neuropathy in observation group was higher than that in control group （P＜0.05）. The incidences of thrombocytopenia （grade 2 or above ），rash and vomiting （grade 2 or above ）in the observation group were lower than those in the control group ，but the difference was not statistically significant （P＞0.05）. There was no significant difference in the incidence of other ADR between 2 groups（P＞0.05）. CONCLUSIONS Albumin-bound paclitaxel combined with nedaplatin inductive chemotherapy followed by concurrent chemoradiotherapy in the treatment of loco-regionally advanced nasopharyngeal carcinoma is effective and tolerable ．
Résumé
Inductive chemotherapy and concurrent chemoradiotherapy have been a focus on the clinical research in the treatment of nasopharyngeal carcinoma.Cisplatin,as a kind of representative platinum drug,can improve the curative effect,but it also brings a lot of side effects to nasopharyngeal carcinoma patients.The new kind of platinum drug-nedaplatin,can not only guarantee the curative effect but also reduce the side effects of chemotherapy.
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4cm) or involved the urethra、 vagina、 clitoris or anus. Pathologic grouping was 25 squamous carcinomas 3 adenocarcinomas and 2 undifferentiated carcinomas. Radiotherapy was given by angled radiation with wedge block. Dose was 65 to 70 Gy/6-7W. RESULTS Thirty patients completed their inductive chemotherapy within 30 days for 86 courses. The response rate was 86. 7% (26/30). CR was 30. 16%. 18 of 30 patients were followed-up for over 5 years. Five years survival rate was 72.2 (13/18). Major acute complications were vuvitis (23%). Late adverse effects were 1 patient with ure-throstenotic uroschesis, 1 patient with pathologic transcervical fracture. None of patients had radiation rectitis and cystitis. CONCLUSION Inductive chemotherapy consisting of modified VBP regimen was active in reducing the vulvar tumor volume. Radiotherapy used angled radiation with wedged block to treat advance vulvar cancer was fa-ciliated. Chemoradiotherapy was found to be an effective treatment for locally advanced vulvar carcinoma, with acceptable morbidity even in an elderly population. The technique allowed maintenance of normal anatomical and physiologic function that would have been compromised by primary surgical approach. It yielded survival rates comparable to those achieved with ultraradical surgery in younger patients. Life quality was improved significant-ly.
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0.05). Conclusions Inductive chemotherapy with 5 fluorouracil, cisplatin, bleomycinA5 plus radiotherapy may improve the outcome of esophageal cancer, with the toxic and side effects of the combined modality severer than radiation alone, but they are well tolerated.